Got the job in ER!

What kinds of things do you see in level two trauma center EDs? I did a senior level rotation in a local level one trauma center and loved everything that I worked with.

This is really going to depend on location. Out there in the ER world, you may see a Level II that basically functions as a Level I in all but name, and you may see a Level II that is really closer to a Level III. Level II is different from Level I in that a Level II is lacking the academic/research piece that Level I facilities include, but clinically you may see similar patients. And this is just speaking about trauma; everything else that comes in the ED is regional/area specific as well. As a new nurse, you probably won't be taking care of trauma patients for a good amount of time, and after you take foundational courses like the Trauma Nursing Core Course (TNCC).

I recommend Sheehy's Emergency Nursing: Principles and Practice as solid reading. Review the heavy hitters: chest pain, stroke, sepsis. I imagine that you'll be taking ACLS/PALS through your employer, and possibly refreshing BLS as necessary, so don't pay for those out of pocket or worry about them at this point if you don't have them now. Since you'll be seeing peds, the Emergency Nursing Pediatric Course (ENPC) may be helpful for you down the road a bit. Congrats and good luck!! :)

Thank you for your advice! I was told by my employer that ENPC was included in the group of certifications that they provide for us. How long did it take you to become comfortable in ED nursing? I know it must take a while!

It does take a while. I was a little different in that I had been a paramedic for 5 years by the time I became an ED RN, and I had also spent 3.5 years as a tech in the same ED where I was hired. I knew the systems/people/policies/procedures, which made the transition a little easier — just a little! There is still a learning curve going from tech to RN, no matter how much time or experience you have before the RN piece comes into play. It took me some months before I didn't have butterflies in my stomach before the start of each shift. And once I started out in triage at the one-year mark, it was another length of time before I stopped snapping to attention every time the door opened and a new patient entered (because you know, there would be those memorable patients who fell out right inside the doors or the terrified parents who footballed their unresponsive baby to you). At some point you realize that you can handle most anything that walks in the door — not necessarily alone, but you know how to act and get the ball rolling in a true emergency.